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Outpatient comprehensive geriatric assessment : effects on frailty and mortality in old people with multimorbidity and high health care utilization

Mazya, Amelie Lindh LU ; Garvin, Peter and Ekdahl, Anne W. LU (2019) In Aging clinical and experimental research 31(4). p.519-525
Abstract

Background: Multimorbidity and frailty are often associated and Comprehensive Geriatric Assessment (CGA) is considered the gold standard of care for these patients. Aims: This study aimed to evaluate the effect of outpatient Comprehensive Geriatric Assessment (CGA) on frailty in community-dwelling older people with multimorbidity and high health care utilization. Methods: The Ambulatory Geriatric Assessment—Frailty Intervention Trial (AGe-FIT) was a randomized controlled trial (intervention group, n = 208, control group n = 174) with a follow-up period of 24 months. Frailty was a secondary outcome. Inclusion criteria were: age ≥ 75 years, ≥ 3 current diagnoses per ICD-10, and ≥ 3 inpatient admissions during 12 months prior to study... (More)

Background: Multimorbidity and frailty are often associated and Comprehensive Geriatric Assessment (CGA) is considered the gold standard of care for these patients. Aims: This study aimed to evaluate the effect of outpatient Comprehensive Geriatric Assessment (CGA) on frailty in community-dwelling older people with multimorbidity and high health care utilization. Methods: The Ambulatory Geriatric Assessment—Frailty Intervention Trial (AGe-FIT) was a randomized controlled trial (intervention group, n = 208, control group n = 174) with a follow-up period of 24 months. Frailty was a secondary outcome. Inclusion criteria were: age ≥ 75 years, ≥ 3 current diagnoses per ICD-10, and ≥ 3 inpatient admissions during 12 months prior to study inclusion. The intervention group received CGA-based care and tailored interventions by a multidisciplinary team in an Ambulatory Geriatric Unit, in addition to usual care. The control group received usual care. Frailty was measured with the Cardiovascular Health Study (CHS) criteria. At 24 months, frail and deceased participants were combined in the analysis. Results: Ninety percent of the population were frail or pre-frail at baseline. After 24 months, there was a significant smaller proportion of frail and deceased (p = 0.002) and a significant higher proportion of pre-frail patients in the intervention group (p = 0.004). Mortality was high, 18% in the intervention group and 26% in the control group. Conclusion: Outpatient CGA may delay the progression of frailty and may contribute to the improvement of frail patients in older persons with multimorbidity.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Community dwelling, Comprehensive Geriatric Assessment, Frailty, Multimorbidity, Outpatient, Randomized controlled trial
in
Aging clinical and experimental research
volume
31
issue
4
pages
519 - 525
publisher
Kurtis
external identifiers
  • pmid:30039453
  • scopus:85050569790
ISSN
1594-0667
DOI
10.1007/s40520-018-1004-z
language
English
LU publication?
yes
id
a14e0d46-7da8-41ec-9442-84b7f81e9cd3
date added to LUP
2018-10-01 11:53:09
date last changed
2020-01-19 05:56:25
@article{a14e0d46-7da8-41ec-9442-84b7f81e9cd3,
  abstract     = {<p>Background: Multimorbidity and frailty are often associated and Comprehensive Geriatric Assessment (CGA) is considered the gold standard of care for these patients. Aims: This study aimed to evaluate the effect of outpatient Comprehensive Geriatric Assessment (CGA) on frailty in community-dwelling older people with multimorbidity and high health care utilization. Methods: The Ambulatory Geriatric Assessment—Frailty Intervention Trial (AGe-FIT) was a randomized controlled trial (intervention group, n = 208, control group n = 174) with a follow-up period of 24 months. Frailty was a secondary outcome. Inclusion criteria were: age ≥ 75 years, ≥ 3 current diagnoses per ICD-10, and ≥ 3 inpatient admissions during 12 months prior to study inclusion. The intervention group received CGA-based care and tailored interventions by a multidisciplinary team in an Ambulatory Geriatric Unit, in addition to usual care. The control group received usual care. Frailty was measured with the Cardiovascular Health Study (CHS) criteria. At 24 months, frail and deceased participants were combined in the analysis. Results: Ninety percent of the population were frail or pre-frail at baseline. After 24 months, there was a significant smaller proportion of frail and deceased (p = 0.002) and a significant higher proportion of pre-frail patients in the intervention group (p = 0.004). Mortality was high, 18% in the intervention group and 26% in the control group. Conclusion: Outpatient CGA may delay the progression of frailty and may contribute to the improvement of frail patients in older persons with multimorbidity.</p>},
  author       = {Mazya, Amelie Lindh and Garvin, Peter and Ekdahl, Anne W.},
  issn         = {1594-0667},
  language     = {eng},
  number       = {4},
  pages        = {519--525},
  publisher    = {Kurtis},
  series       = {Aging clinical and experimental research},
  title        = {Outpatient comprehensive geriatric assessment : effects on frailty and mortality in old people with multimorbidity and high health care utilization},
  url          = {http://dx.doi.org/10.1007/s40520-018-1004-z},
  doi          = {10.1007/s40520-018-1004-z},
  volume       = {31},
  year         = {2019},
}